Individual provider Active NPI

Phillip A Speake, PA-C

  • Surgical Physician Assistant
  • Stuart, FL
National Provider Identifier
1669344503
Registry record updated Sep 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9120747 Issued in FL
Practice address
200 SE Hospital Ave
Stuart, FL 34994-2346
Phone
(772) 287-5200
NPI assigned
Sep 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 9120747 FL Primary

Addresses

Primary practice location

200 SE Hospital Ave
Stuart, FL 34994-2346

Mailing address

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 287-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013003409 FL Practitioner - Physician Assistant 0042707218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 223-5665

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9120747FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Oct 14, 2025 Accepting new patients
Martin Memorial Medical Center Inc Current Accepting new patients

Locations

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758326400000",
    "number": "1669344503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-287-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-287-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAKE",
        "first_name": "PHILLIP",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-20",
        "last_updated": "2025-09-20",
        "certification_date": "2025-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9120747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.